Kim Jiyoon, Lee Haebeom, Jeong Jaemin, Jeon YoungJin
Department of Veterinary Surgery, College of Veterinary Medicine, Chungnam National University, Daejeon, Republic of Korea.
Front Vet Sci. 2025 Sep 5;12:1637089. doi: 10.3389/fvets.2025.1637089. eCollection 2025.
Lumbosacral foraminal stenosis (LSFS) in dogs, a subtype of degenerative lumbosacral disease, leads to nerve root compression and clinical signs such as pain or pelvic limb dysfunction. Traditional decompression techniques-such as dorsal laminectomy or lateral foraminotomy-have limitations, including restricted access, tissue disruption, and prolonged recovery. To address these challenges, this study evaluated the technical feasibility and safety of biportal endoscopic lumbosacral foraminotomy (BELF), a minimally invasive technique adapted from human unilateral biportal endoscopy (UBE), for decompressing the lumbosacral foramina in canine cadavers.
BELF was performed bilaterally on nine canine cadavers (18 foramina) after initial refinement in a pilot study using three cadavers. Key outcome measures included computed tomography (CT)-based measurements of foraminal area at the entry, middle, and exit zones pre-and postoperatively, intraoperative endoscopic video evaluation of anatomical visualization and surgical performance, and a feasibility scoring system (ratings: Excellent, Good, Fair, Poor).
BELF was successfully completed in all specimens without causing damage to normal anatomical structures or requiring conversion to open surgery. The mean operative time was 42.17 ± 13.27 min. Postoperative CT showed significant foraminal enlargement at all level; entry (+53.8%), middle (+81.6%), and exit (+119.8%) compared to preoperative measurements (all < 0.001). Critical anatomical structures were preserved with clear endoscopic visualization, and all procedures were rated as Excellent or Good on the feasibility scale.
BELF enabled effective and minimally invasive decompression of the lumbosacral foramina with no observed damage to critical anatomical structures. These results support the feasibility of BELF and its potential clinical utility in managing LSFS in dogs.
犬腰骶部椎间孔狭窄（LSFS）是退行性腰骶部疾病的一种亚型，可导致神经根受压及疼痛或后肢功能障碍等临床症状。传统的减压技术，如背侧椎板切除术或外侧椎间孔切开术，存在局限性，包括手术入路受限、组织破坏和恢复时间延长。为应对这些挑战，本研究评估了双门内镜腰骶部椎间孔切开术（BELF）的技术可行性和安全性，这是一种从人类单侧双门内镜（UBE）改编而来的微创技术，用于在犬类尸体上减压腰骶部椎间孔。
在一项前期研究中，使用3具尸体进行初步改进后，对9具犬类尸体（18个椎间孔）双侧实施BELF。主要观察指标包括术前和术后基于计算机断层扫描（CT）测量的椎间孔入口、中部和出口区域的面积，术中内镜视频评估解剖结构的可视化和手术操作情况，以及可行性评分系统（评分：优秀、良好、中等、差）。
所有标本均成功完成BELF，未对正常解剖结构造成损伤，也无需转为开放手术。平均手术时间为42.17±13.27分钟。术后CT显示各层面椎间孔均有显著扩大；与术前测量值相比，入口处扩大了53.8%，中部扩大了81.6%，出口处扩大了119.8%（均P<0.001）。关键解剖结构得以保留，内镜视野清晰，所有手术在可行性评分中均评为优秀或良好。
BELF能够有效且微创地减压腰骶部椎间孔，未观察到对关键解剖结构的损伤。这些结果支持了BELF在犬类LSFS治疗中的可行性及其潜在的临床应用价值。
